1. Define TENS
    transcutaneous electrical nerve stimulation
  2. Contraindications for TENS
    • Undiagnosed pain - unless recommended by medical practitioner
    • Heart Disease - clear with cardiologist
    • Epilepsy
    • Pregnancy - first trimester and over the uterus
    • Do not apply over carotid sinus, on broken skin, internally
  3. Common pulse waveforms used in TENS
    • Monophasic pulsed
    • Symmetrical biphasic pulsed
    • Balanced asymmetrical biphasic pulsed
    • Spike like biphasic pulsed
  4. Conventional TENS
    • Uses: more acute conditions, gating mechanism
    • Optimal Elcetrode Sites: dermatomes, cutaneous intervation or peripheral nerve to areas of pain
  5. Conventional TENS Settings
    • High Frequency
    • Low intensity
    • Short Duration
    • 20-60min treatment
    • Temporary relief
  6. Acupuncture like TENS
    • Uses: more chronic conditions endorphine response
    • Optimal electrode sites: myotomes, superficial motor points, nerves, acupuncture and trigger points
  7. Acupuncture like TENS settings
    • strong low frequency to be tolerance
    • low frequency
    • long duration
    • pain relief takes 20-30 mins post treatment
  8. Define Train/cycle burst
    a modulation which combines high and low frequency modes
  9. Burst TENS settings
    • intensity comfortable
    • Rate high
    • burst low
    • duration variable
    • Treatment time 20-60mins
    • long lasting pain relief
  10. Define HVPC
    • HVPC is the application of monophasic direct current to the body with a known polarity under each set of electores
    • uses a twin peaked waveform or a train of two single pulses with a very short phase duration
    • average current is low and low pulse charge results
  11. HVPC for gait
    • intensity - sensory
    • frequency - high
    • low pulse duration
    • continuous mode
    • electrodes over painful site
  12. HVPC for opiate
    • motor intensity
    • low frequency
    • long duration
    • continuous mode
    • electrode placement over painful site
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